Provider Demographics
NPI:1720233927
Name:NICHOLS, CHRISTIANA CELESTE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIANA
Middle Name:CELESTE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:29 CLAREMONT AVE
Mailing Address - Street 2:SUITE 1S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6814
Mailing Address - Country:US
Mailing Address - Phone:212-864-1744
Mailing Address - Fax:212-864-1058
Practice Address - Street 1:29 CLAREMONT AVE
Practice Address - Street 2:SUITE 1S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6814
Practice Address - Country:US
Practice Address - Phone:212-864-1744
Practice Address - Fax:212-864-1058
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245118208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics